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Thursday, 20 December 2012

A Christmas Blogpost

And so, it’s That Season again. The time of year to do everything with alcohol and food which Public Health Guidelines say you shouldn’t, the time of year to tie-dye six multi-packs of Primark socks as Christmas and/or Hannukah presents for your ever-burgeoning brood of nephews and nieces, the time of year to argue with one’s partner about whose should come to fix your perennially inept combi-boiler. Happy times. Well, maybe; maybe not. This year, things do feel different.

This year does feel very different. It’s the first time – within my lifetime, at least – that such austerity and hardship and poverty in Britain have been so widespread. Certainly, this country has always had its marginalised and disadvantaged and poor... but the food banks, and the stories of people walking ten miles on foot to reach one because they cannot afford the bus fare, and the talk of “nutritional recession”: that’s new. It’s new, and it’s frightening. It reminds us that we live in one of the most unequal countries in the developed world and that, whereas that inequality is getting worse, we are most of us just one job loss, one relationship breakdown or one investment disaster away from destitution.

And so, it’s That Season again. The time of the year to think about Those Less Fortunate Than Ourselves, the time of year to try and decide whether to donate to That Charity or to get angry about the need for That Charity even to exist, the time of year to give an extra few quid to the Big Issue seller and to awkwardly wish him a merrier Christmas than he’ll probably be having. And so, I’m now going to propose that we in Public Health research do need to invest some more thought about what we’re doing to address this new sort of poverty and hunger we’re seeing across Britain. Do we organise collections and donations for our local homeless charity, or do we set up evaluations of cookery classes for vulnerable families, do we invite Osborne round to tea for a chat about the bankers and their bonuses, or do we set up a protest camp and get radical?

I don’t know what the answer is, I really don’t. But let’s talk about it, anyway...

2 comments:

Thanks Heather, for such a thought provoking and apt Christmas blog post. I think our responses will, inevitably, fall into a number of categories. At a personal level, we need to make choices as citizens, whether moral (e.g. about charitable giving or volunteering) or political (e.g. who to vote for next time we get the chance, and whether to become politically active in advance of that opportunity).

However, in response to your question, as public health researchers, I think the answer is clearer. I have always urged Fuse to focus strategically on the most important issues that affect population health, and by and large I think we do this. However, we do also need to be responsive, refreshing our strategy as new public health threats emerge. The present government's political and fiscal actions pose such a threat, placing an onus on us to include these in our future research.

We have again placed health inequalities centre stage in our renewal strategy for the next five years, as well as included focuses on the emerging public health system, and the roles of local government and the commercial sector in public health. However, our aims should be not only to observe, describe and bear witness to these challenges as they emerge, but to do research that clearly identifies the root causes and effective solutions. If this leads us to challenge government or other vested interests, so be it. But, in doing so, we need to draw a clear line between our individual and collective moral viewpoints, and objective science. This should not present us with any major conflicts, but we need to resist the temptation, in our research, to take a moral stand on the political issues. Instead, let us ensure that our results speak compellingly for themselves.

Martin, I agree. The history of public health is very much one of challenging viewpoints by demanding that experimental results be allowed to speak for themselves, often with very exciting outcomes. But now that public health in the UK has become less about pathogens and more about people, we are now primarily studying one another and thus ourselves, with the result that Subject and Object begin to tangle and the empiricist model of scientific detachment begins to falter. This poses the timeworn questions of whether any research can ever be fully value-neutral, and thereby whether any piece of public health evidence or process of knowledge exchange can ever remain entirely untainted by politics, ideology or personal or collective morality. Either way, though, I think the diversity of academic backgrounds and methodological perspectives within the strategy-generation and teamwork of Fuse speaks very effectively to such questions...

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